TY - JOUR
T1 - Analysis of tuberculosis transmission between nationalities in the Netherlands in the period 1993-1995 using DNA fingerprinting
AU - Borgdorff, Martien W.
AU - Nagelkerke, Nico
AU - Van Soolingen, Dick
AU - De Haas, Petra E.W.
AU - Veen, Jaap
AU - Van Embden, Jan D.A.
PY - 1998/1/15
Y1 - 1998/1/15
N2 - Immigration from high prevalence areas may contribute to an increased risk of tuberculosis in Europe. This study aimed at quantifying transmission of tuberculosis between and within nationalities among residents of the Netherlands. DNA 'fingerprints,' on the basis of restriction fragment length polymorphism using marker IS6110, were made of all Mycobacterium tuberculosis isolates in the Netherlands from January 1993 through June 1995. Clusters were defined as groups of patients that had isolates with identical fingerprints. It was assumed that the probability of a patient being the source of a cluster was proportional to the incidence rate of potential sources times the probability that a potential source would give rise to a cluster. The transmission index was defined as the average number of secondary cases of infectious tuberculosis caused directly or indirectly through recent transmission by a single potential source case and was used to estimate the effective reproductive rate associated with recent transmission, R(FAST). Among a total of 623 Dutch tuberculosis cases, 17% (95% confidence interval 9-25%) of cases were attributable to recent transmissions from a non-Dutch source. The transmission index varied strongly by nationality, and was highest among the Surinamese (1.3), Moroccan (0.8) and Turkish (0.8) populations; R(FAST) was 0.26. Aggregation of tuberculosis cases of given nationalities within clusters was most pronounced among recent immigrants from Somalia and (ex-)Yugoslavia. The authors conclude that differences in transmission between subpopulations can be quantified and may be used to evaluate and direct tuberculosis control.
AB - Immigration from high prevalence areas may contribute to an increased risk of tuberculosis in Europe. This study aimed at quantifying transmission of tuberculosis between and within nationalities among residents of the Netherlands. DNA 'fingerprints,' on the basis of restriction fragment length polymorphism using marker IS6110, were made of all Mycobacterium tuberculosis isolates in the Netherlands from January 1993 through June 1995. Clusters were defined as groups of patients that had isolates with identical fingerprints. It was assumed that the probability of a patient being the source of a cluster was proportional to the incidence rate of potential sources times the probability that a potential source would give rise to a cluster. The transmission index was defined as the average number of secondary cases of infectious tuberculosis caused directly or indirectly through recent transmission by a single potential source case and was used to estimate the effective reproductive rate associated with recent transmission, R(FAST). Among a total of 623 Dutch tuberculosis cases, 17% (95% confidence interval 9-25%) of cases were attributable to recent transmissions from a non-Dutch source. The transmission index varied strongly by nationality, and was highest among the Surinamese (1.3), Moroccan (0.8) and Turkish (0.8) populations; R(FAST) was 0.26. Aggregation of tuberculosis cases of given nationalities within clusters was most pronounced among recent immigrants from Somalia and (ex-)Yugoslavia. The authors conclude that differences in transmission between subpopulations can be quantified and may be used to evaluate and direct tuberculosis control.
KW - Clustering
KW - Epidemiology, molecular
KW - Polymorphism, restriction fragment length
KW - Transmission
KW - Tuberculosis
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U2 - 10.1093/oxfordjournals.aje.a009433
DO - 10.1093/oxfordjournals.aje.a009433
M3 - Article
C2 - 9457010
AN - SCOPUS:0032518737
SN - 0002-9262
VL - 147
SP - 187
EP - 195
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
IS - 2
ER -